Intervention effect of antimicrobial prophylaxis in patients undergoing craniotomy for tumor resection

Abstract:

ObjectiveTo evaluate the effect of multidisciplinary intervention on antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.MethodsBy standardizing preoperative disinfection and surgical procedures, training and education of antimicrobial use, conducting quality control activities, and performing periodic feedback of supervised results, efficacy of improvement of antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection in a hospital was observed.ResultsIn 2013 and 2014, incidences of surgical site infection(SSI) were 7.66%（17/222）and 6.80%（27/397） respectively，there was no significant difference between two groups（χ2 =0.158，P＞0.05）. Prophylactic use of antimicrobial agents in surgical patients were as follows: cefuroxime(n=495), cefazolin(n=103), cefathiamidine(n=9), clindamycin(n=8), and cefotaxime(n=4), types of used antimicrobial agents were rational. In 2014, the implementation rate of necessary intraoperative antimicrobial adding was 95.02%, which was higher than 87.66% in 2013（χ2=7.969，P＜0.05）, 30.73% of patients received antimicrobial prophylaxis for>48 hours, which was lower than 57.66% in 2013, difference was significant（χ2=42.88，P＜0.05）.ConclusionMultiintervention measures, including standard preoperative disinfection and surgical procedures, education and training, quality control circle, and feedback of supervised results can improve standard antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.